Budget maintains a healthy weight

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Stephen Leeder does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

We were chilled by the prospect of a radical weight-loss austerity budget, but it did not occur in health.

While liposuction was applied to several programs – hearing services and general practice-based psychiatric support sessions, for example – serious surgical enhancements (several billion dollars) for mental health and rural hospitals and community health facilities more than balanced these losses.

The emphasis in the budget on rural and regional development will carry implications for health as more health care facilities will be needed to support this growth.

The recent round of funding for capital development of rural and regional health settings through the Health and Hospitals Fund will assist in providing infrastructure.

But staffing remains a major problem and this is not easily solved with money alone.

Threatened cuts of hundred of hundreds of millions of dollars from medical research were leaked weeks ahead of the budget, possibly as distracters, leading to a flurry of outrage from research workers.

Straw man or real, the cuts did not happen and research laboratories around the nation are celebrating.

First, it is a lot of money for a traditionally underfunded area that has been the cause of massive criticism of governments, state and federal, over decades.

Second, it takes seriously the context of people with mental illness who often struggle with social deprivation, poor housing and limited employment opportunities by funding social support as well as medical services.

Third, the new National Mental Health Commission is to be located in the office of the prime minister, recognising the importance of cross-portfolio action to improve the lot of those with mental illness. We are learning.

A similar cross-portfolio arrangement is proposed for the Indigenous “Close the Gap” program running at about $100 million a year for five years.

Teeth get a dusting in this budget with money for an advisory council and dental internships. But don’t expect many eruptions soon.

Consideration of dental care schemes was part of the health reform agenda three years ago but when the billion dollar costs were calculated, political enthusiasm waned and we are back to the point where the federal government payments for dental care are nearly all laundered through private health insurance subsidy.

At least it seems that the payment for dental services to people with chronic illnesses has not been cut. Nor have pharmaceutical subsidies, although changes to subsidies for older drugs may be buried in fine print.

Like surveying what’s left in a department store after a Boxing Day sale, there remains an untidy pile of little surprises in the budget, both pleasant and nasty, that will slowly come to light.

But this is a budget that has done health quite well, especially mental health, given the commitment to austerity. Weight is steady.